Does the length of maternity leave affect maternal health?
Southern Economic Journal › Vol. 72 Nbr. 1, July 2005
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Does the length of maternity leave affect maternal health?
1. Introduction
In the United States, 51% of mothers of infants currently work outside the home (Bureau of Labor Statistics 2003). Among mothers who return to work during the first year after childbirth, almost all return to work by the third month (Klerman and Leibowitz 1994; Cantor et al. 2001). The large number of infants with employed mothers has led to an increased interest in the effects of maternal employment during infancy on child health and development. Recent studies suggest that some forms of maternal employment during the child's first year are detrimental to children's cognitive development and lead to more behavioral problems (Blau and Grossberg 1992; BrooksGunn, Han, and Waldfogel, 2002; Waldfogel, Han, and Brooks-Gunn 2002; Baum 2003). These studies imply that longer maternal leaves will benefit children. Previous research, however, does not consider that in addition to improving children's health and development, longer maternity leaves also may affect the health and well-being of mothers. A few correlational studies in the public health literature show that women who are employed postpartum or who return to work soon after childbirth experience more mental and physical health symptoms than other women (Gjerdingen et al. 1993, 1995; Hyde et al. 1995), perhaps because of increased stress and obligations. While the detrimental effects of physical and mental health problems to the mother are obvious, these conditions also may affect the child and other family members through emotional and financial distress. We know very little about this aspect of maternal employment despite the large number of women in the United States who currently balance a job outside the home with the care of a young infant (Hyde 1995). From a policy perspective, it is useful to consider the effect of maternity leave length on both mothers and children. Concerns about the health of infants and postpartum women were motivating forces behind the Family and Medical Leave Act (FMLA) of 1993. The case for longer leaves is bolstered if longer leaves benefit mothers as well as children. In the case that longer leaves have neutral or detrimental effects on maternal health, this information still is needed to inform the debate over family leave policy. To date, however, despite a number of recent studies on maternal employment and child health, there is little empirical evidence regarding whether longer maternity leave affects maternal health (Hyde 1995). This evidence is still needed today despite the passage of the FMLA because states currently are passing or are considering legislation that would provide paid family leave. This policy change would likely increase the length of maternity leave but at a cost to states, employees, and businesses. Without information about the health impact of longer maternal leave after childbirth, it is difficult to weigh the costs and benefits of these proposed state-level policy changes. This paper investigates how the length of maternity leave affects maternal health in a sample of mothers who returned to work after childbirth. Data come from the National Maternal and Infant Health Survey (NMIHS) of 1988. This survey is particularly useful because it was conducted before the FMLA was enacted in 1993, allowing us to use empirical methods that take advantage of pre-FMLA variation in maternal leave policies across states. Maternal health is represented by three measures. As discussed further here, the first two examine depressive symptoms using the Center for Epidemiological Studies Depression (CES-D) Scale, a widely used screening tool for depression. The third measure of maternal health represents overall health and is a dummy variable indicating whether the mother had at least three outpatient visits for any health problems (mental or physical) during the first six months after childbirth. We estimate baseline models using ordinary least squares (OLS) methods and then address the potential endogeneity of the return-to-work decision using instrumental variables (IV) methods. The results indicate that among employed mothers of infants, delaying the return to work decreases the number of depressive...See the full content of this document
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